OBJECTIVE:To analyze health service use patterns in communities covered by the Estratégia de Saúde da Família (Family Health Strategy). METHODS:Population-based cross-sectional study with a sample of 2,988 individuals, of all ages, living in areas covered by the Estratégia de Saúde da Família, in the city of Porto Alegre, Southern Brazil, between July and September 2003. Pre-coded questionnaires about demographic, socioeconomic and health information were applied to all residents of selected households. Prevalence ratios and 95% confi dence intervals were calculated and chisquare tests were applied in the analyses. Poisson regression was used in the multivariable analysis to control for potential confounding factors. RESULTS:Females, persons aged 60 years or older, white, with better socioeconomic level, without health care plan coverage and with poor health self-perception were more likely to use the local family health unit. Regarding users of other health services, a similar pattern for sex, age and health selfperception was observed. However, greater use was found among people with better socioeconomic level and with health care plan coverage. CONCLUSIONS:Use of a local family health unit was greater among people from a lower socioeconomic level and without health care plan coverage, revealing the poorer individuals to be the priority of governmental actions. Model changes made to health care with the implementation of the Estratégia Saúde da Família tend to progressively improve the health conditions of the poorer population, with consequent reduction of health inequalities.

Gerência de serviços de saúde: competências desenvolvidas e dificuldades encontradas na atenção básicaManagement of health services: developed competencies and difficulties found in basic attention